Patient is referred from ENT for a Audiovestibular assessment.
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Take detailed history from patient.
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Perform Tympanometry
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Perform Pure Tone Audiometry
| YES
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Perform bedside tests
to check for conjugate eye movements and also perform head thrust and SKEW test.
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Perform
CTSIB
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YES
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YES
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YES
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Perform Otoscopy
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Perform Calorics
| YES
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Perform either VNG/ENG
and conduct Smooth pursuit, Saccades, Gaze, and positionals
| YES
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Perfom Dynamic Visual acuity
| YES
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Perform Dix Halpike if history indicates BPPV
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NO
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YES
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Perfrom VEMPS, rotating chair and head shake
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Debrief patient about results
| YES
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Decide whether Customised vestibular exercies are appropriate
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Book follow up appointment if they are to see them in a few weeks
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NO
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NO
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Refer patient back to ENT
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